2,879
Views
1
CrossRef citations to date
0
Altmetric
Editorial

“Head Up CPR” Is Not Ready for Widespread Adoption

ORCID Icon, ORCID Icon, ORCID Icon, ORCID Icon & ORCID Icon
Pages 745-747 | Received 21 Dec 2023, Accepted 13 Feb 2024, Published online: 28 Feb 2024

References

  • Metro Fire Chiefs: First-In Responders Providing Neuroprotective (“Heads-Up”) CPR as the Standard of Care for Emergency Medical Services Systems. NFPA. [accessed January 8, 2024] https://web.archive.org/web/20231003185339/https://www.nfpa.org/-/media/Files/Membership/member-sections/Metro-Chiefs/Urban-Fire-Forum/2023/UFF23_NPCPR-Position-Statement.ashx.
  • Carey B. NFPA: metro chiefs announce positions on critical fire, EMS issues.NFPA: metro chiefs announce positions on critical fire, EMS issues [accessed 2024 Jan 8]. https://www.firerescue1.com/nfpa/articles/nfpa-metro-chiefs-announce-positions-on-critical-fire-ems-issues-gajgYgCNQwAHQSmI/.
  • Carey B. NFPA: metro chiefs rescind positions on EMS issues.ems1.com [accessed 2023 Nov 3]. https://www.ems1.com/cpr/articles/nfpa-metro-chiefs-rescind-positions-on-ems-issues-JxI6o2d0QIM4O4hQ/.
  • Moore JC, Segal N, Lick MC, Dodd KW, Salverda BJ, Hinke MB, Robinson AE, Debaty G, Lurie KG. Head and thorax elevation during active compression decompression cardiopulmonary resuscitation with an impedance threshold device improves cerebral perfusion in a swine model of prolonged cardiac arrest. Resuscitation. 2017;121:195–200. doi:10.1016/j.resuscitation.2017.07.033.
  • Moore JC, Salverda B, Rojas-Salvador C, Lick M, Debaty G, G Lurie K. Controlled sequential elevation of the head and thorax combined with active compression decompression cardiopulmonary resuscitation and an impedance threshold device improves neurological survival in a porcine model of cardiac arrest. Resuscitation. 2021;158:220–7. doi:10.1016/j.resuscitation.2020.09.030.
  • Debaty G, Shin SD, Metzger A, Kim T, Ryu HH, Rees J, McKnite S, Matsuura T, Lick M, Yannopoulos D, et al. Tilting for perfusion: head-up position during cardiopulmonary resuscitation improves brain flow in a porcine model of cardiac arrest. Resuscitation. 2015;87:38–43. doi:10.1016/j.resuscitation.2014.11.019.
  • Ryu HH, Moore JC, Yannopoulos D, Lick M, McKnite S, Shin SD, Kim TY, Metzger A, Rees J, Tsangaris A, et al. The effect of head up cardiopulmonary resuscitation on cerebral and systemic hemodynamics. Resuscitation. 2016;102:29–34. doi:10.1016/j.resuscitation.2016.01.033.
  • Moore JC, Salverda B, Lick M, Rojas-Salvador C, Segal N, Debaty G, Lurie KG. Controlled progressive elevation rather than an optimal angle maximizes cerebral perfusion pressure during head up CPR in a swine model of cardiac arrest. Resuscitation. 2020;May150:23–8. doi:10.1016/j.resuscitation.2020.02.023.
  • Rojas-Salvador C, Moore J, Salverda B, Lick M, Debaty G, Lurie K. Effect of controlled sequential elevation timing of the head and thorax during cardiopulmonary resuscitation on cerebral perfusion pressures in a porcine model of cardiac arrest. Resuscitation. 2020;149:162–9. doi:10.1016/j.resuscitation.2019.12.011.
  • Jaeger D, Kosmopoulos M, Voicu S, Kalra R, Gaisendrees C, Schlartenberger G, Bartos JA, Yannopoulos D. Cerebral hemodynamic effects of Head-up CPR in a porcine model. Resuscitation. 2023;193:110039. (Epub ahead of print). doi:10.1016/j.resuscitation.2023.110039.
  • Pepe PE, Scheppke KA, Antevy PM, Crowe RP, Millstone D, Coyle C, Prusansky C, Garay S, Ellis R, Fowler RL, et al. Confirming the clinical safety and feasibility of a bundled methodology to improve cardiopulmonary resuscitation involving a head-up/torso-up chest compression technique. Crit Care Med. 2019;47(3):449–55. doi:10.1097/CCM.0000000000003608.
  • Moore JC, Duval S, Lick C, Holley J, Scheppke KA, Salverda B, Rojas-Salvador C, Jacobs M, Nystrom P, Quinn R, et al. Faster time to automated elevation of the head and thorax during cardiopulmonary resuscitation increases the probability of return of spontaneous circulation. Resuscitation. 2022;170:63–9. doi:10.1016/j.resuscitation.2021.11.008.
  • Moore JC, Pepe PE, Scheppke KA, Lick C, Duval S, Holley J, Salverda B, Jacobs M, Nystrom P, Quinn R, et al. Head and thorax elevation during cardiopulmonary resuscitation using circulatory adjuncts is associated with improved survival. Resuscitation. 2022;179:9–17. doi:10.1016/j.resuscitation.2022.07.039.
  • Bachista KM, Moore JC, Labarère J, Crowe RP, Emanuelson LD, Lick CJ, Debaty GP, Holley JE, Quinn RP, Scheppke KA, et al. Survival for nonshockable cardiac arrests treated with noninvasive circulatory adjuncts and head/thorax elevation. Crit Care Med. 2024;52(2):170–81. doi:10.1097/CCM.0000000000006055.
  • Stiell IG, Nichol G, Leroux BG, Rea TD, Ornato JP, Powell J, Christenson J, Callaway CW, Kudenchuk PJ, Aufderheide TP, et al. Early versus later rhythm analysis in patients with out-of-hospital cardiac arrest. N Engl J Med. 2011;365(9):787–97. doi:10.1056/NEJMoa1010076.
  • Aufderheide TP, Nichol G, Rea TD, Brown SP, Leroux BG, Pepe PE, Kudenchuk PJ, Christenson J, Daya MR, Dorian P, et al. A trial of an impedance threshold device in out-of-hospital cardiac arrest. N Engl J Med. 2011;365(9):798–806. doi:10.1056/NEJMoa1010821.
  • Aufderheide TP, Frascone RJ, Wayne MA, Mahoney BD, Swor RA, Domeier RM, Olinger ML, Holcomb RG, Tupper DE, Yannopoulos D, et al. Standard cardiopulmonary resuscitation versus active compression-decompression cardiopulmonary resuscitation with augmentation of negative intrathoracic pressure for out-of-hospital cardiac arrest: a randomised trial. Lancet. 2011;377(9762):301–11. doi:10.1016/S0140-6736(10)62103-4.
  • Kudenchuk PJ, Brown SP, Daya M, Rea T, Nichol G, Morrison LJ, Leroux B, Vaillancourt C, Wittwer L, Callaway CW, et al. Amiodarone, lidocaine, or placebo in out-of-hospital cardiac arrest. N Engl J Med. 2016;374(18):1711–22. doi:10.1056/NEJMoa1514204.
  • Mohan M, Swaminathan AK. Heads Up! data dredging coming through: heads up cardiopulmonary resuscitation does not improve outcomes. Ann Emerg Med. 2023;81(2):244–5. doi:10.1016/j.annemergmed.2022.12.018.
  • Breznau N, Rinke EM, Wuttke A, Nguyen HHV, Adem M, Adriaans J, Alvarez-Benjumea A, Andersen HK, Auer D, Azevedo F, et al. Observing many researchers using the same data and hypothesis reveals a hidden universe of uncertainty. Proc Natl Acad Sci U S A. 2022;119(44):e2203150119.
  • What is GRADE? https://bestpractice.bmj.com/info/us/toolkit/learn-ebm/what-is-grade/.
  • Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, Schünemann HJ, GRADE Working Group GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336(7650):924–6. doi:10.1136/bmj.39489.470347.AD.
  • Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, Norris S, Falck-Ytter Y, Glasziou P, DeBeer H, et al. GRADE guidelines: 1. Introduction—GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 2011;64(4):383–94. doi:10.1016/j.jclinepi.2010.04.026.
  • Schünemann HJ, Brennan S, Akl EA, Hultcrantz M, Alonso-Coello P, Xia J, Davoli M, Rojas MX, Meerpohl JJ, Flottorp S, et al. The development methods of official GRADE articles and requirements for claiming the use of GRADE—a statement by the GRADE guidance group. J Clin Epidemiol. 2023;159:79–84. doi:10.1016/j.jclinepi.2023.05.010.
  • Huang C-C, Chen K-C, Lin Z-Y, Chou Y-H, Chen W-L, Lee T-H, Lin K-T, Hsieh P-Y, Chen CH, Chou C-C, et al. The effect of the head-up position on cardiopulmonary resuscitation: a systematic review and meta-analysis. Crit Care. 2021;25(1):376. doi:10.1186/s13054-021-03797-x.
  • Wyckoff MH, Singletary EM, Soar J, Olasveengen TM, Greif R, Liley HG, Zideman D, Bhanji F, Andersen LW, Avis SR, et al. International consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations: summary from the Basic Life Support; Advanced Life Support; Neonatal Life Support; Education, Implementation, and Teams; First Aid Task Forces; and the COVID-19 Working Group. Circulation. 2021;148(24):e187–e280.
  • Berg KM, Bray JE, Ng K-C, Liley HG, Greif R, Carlson JN, Morley PT, Drennan IR, Smyth M, Scholefield BR, et al. 2023 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: summary from the basic life support; advanced life support; pediatric life support; neonatal life support; education, implementation, and teams; and first aid task forces. Circulation. 2023;148(24):e187–e280.
  • Bass RR. The pneumatic anti-shock garment: lessons we should have learned. Prehosp Emerg Care. 1997;1(1):59–61. doi:10.1080/10903129708958786.
  • Mattox KL, Bickell W, Pepe PE, Burch J, Feliciano D. Prospective MAST study in 911 patients. J Trauma. 1989;29(8):1104–12. discussion 1111–1112. doi:10.1097/00005373-198908000-00007.
  • Bickell WH, Wall MJ, Pepe PE, Martin RR, Ginger VF, Allen MK, Mattox KL. Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. N Engl J Med. 1994;331(17):1105–9. doi:10.1056/NEJM199410273311701.
  • Lin S, Callaway CW, Shah PS, Wagner JD, Beyene J, Ziegler CP, Morrison LJ. Adrenaline for out-of-hospital cardiac arrest resuscitation: a systematic review and meta-analysis of randomized controlled trials. Resuscitation. 2014;85(6):732–40. doi:10.1016/j.resuscitation.2014.03.008.
  • Vallentin MF, Granfeldt A, Meilandt C, Povlsen AL, Sindberg B, Holmberg MJ, Iversen BN, Mærkedahl R, Mortensen LR, Nyboe R, et al. Effect of intravenous or intraosseous calcium vs saline on return of spontaneous circulation in adults with out-of-hospital cardiac arrest: a randomized clinical trial. JAMA. 2021;326(22):2268–76. doi:10.1001/jama.2021.20929.
  • Nichol G, Leroux B, Wang H, Callaway CW, Sopko G, Weisfeldt M, Stiell I, Morrison LJ, Aufderheide TP, Cheskes S, et al. Trial of continuous or interrupted chest compressions during CPR. N Engl J Med. 2015;373(23):2203–14. (Epub ahead of print). doi:10.1056/NEJMoa1509139.
  • Schmicker RH, Nichol G, Kudenchuk P, Christenson J, Vaillancourt C, Wang HE, Aufderheide TP, Idris AH, Daya MR. CPR compression strategy 30:2 is difficult to adhere to, but has better survival than continuous chest compressions when done correctly. Resuscitation. 2021;165:31–7. doi:10.1016/j.resuscitation.2021.05.027.
  • Gonzales L, Oyler BK, Hayes JL, Escott ME, Cabanas JG, Hinchey PR, Brown LH. Out-of-hospital cardiac arrest outcomes with “pit crew” resuscitation and scripted initiation of mechanical CPR. Am J Emerg Med. 2019;37(5):913–20. doi:10.1016/j.ajem.2018.08.031.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.